Researchers in the United Kingdom have identified genetics, obesity and
degree of lumbar disc degeneration as assessed by MRI as the main risk factors
for severe or disabling low back pain in women.
According to investigators, the research could help physicians identify
different mechanisms involved in back pain and lead to more effective treatment
options. The findings, published in Annals of Rheumatic Diseases,
point toward genetics playing a key role in low back pain and the deterioration
of intervertebral discs. The investigators also found that low back pain and
disc degeneration do not always overlap and are caused by different genetic
We have genetic factors that affect the rate and extent of the
degeneration of our discs, lead author Gregory Livshits, PhD, stated in a
press release. In fact, the genetic factors are second only to age. On
the other side, we have different genetic factors that independently cause
lower back pain (LBP). These are mechanisms not involved in spine
The researchers performed a cross-sectional study of 2,256 women that
included 371 monozygotic and 698 dizygotic twin pairs, as well as 29 sibling
pairs and 60 individuals. Back pain data was collected through a self-reported
validated questionnaire, and measurements were taken of risk factors such as
MRI-assessed lumbar disc degeneration (LDD), body weight, smoking, occupation
and physical exercise.
The major factors associated with [low back pain] included genetic
background, with [an odds ratio] of approximately six if the monozygotic
co-twin had LBP, or 2.2 if she was a dizygotic co-twin, the authors
Significant genetic correlation
The authors also found LDD and obesity were also significantly
associated with non-specific LBP, with the overall amount of LDD serving as the
most important risk factor. LBP manifestation was 3.2 times more likely in
those individuals who demonstrated advanced LDD.
Furthemore, they noted, there was a significant genetic
correlation between LBP and LDD measurements in the study implying
LDD and LBP share around 11% to 13% of genetic effects.
Livshits noted in the release that more research on the genetic causes
of back pain is required, and a broader genome search of affected and
non-affected individuals should be a part of such studies.
- Livshits G, Popham M, Malkin I, et al. Lumbar disc degeneration and
genetic factors are the main risk factors for low back pain in women: the UK
Twin Spine Study. Ann Rheum Dis. 2011. doi:10.1136/ard.2010.137836
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